Consensus recommendations for the management of Dato-DXd-associated adverse events in patients with advanced/metastatic NSCLC: insights from a multiregional steering committee

Datopotamab deruxtecan (Dato-DXd) is a novel antibody-drug conjugate currently under investigation in clinical trials of various solid tumors. In this manuscript, an international steering committee formed by medical oncologists, ophthalmologists, and pulmonologists reached consensus to provide multidisciplinary healthcare professionals (HCPs) with practical recommendations for Dato-DXd adverse event (AE) prevention, monitoring, and management in patients with advanced/metastatic non-small cell lung cancer. Experts’ recommendations focused on the following AEs: oral mucositis/stomatitis, interstitial lung disease/pneumonitis, ocular surface events, nausea, and vomiting. Based on available guidelines, clinical trials data, and real-world experience, 55 statements were developed and, as per Delphi methodology, all reached consensus with more than 75% of experts’ agreement. The key recommendations include preventive measures, such as proactive communication between patients and caretakers, regular clinical examinations, collaboration with multidisciplinary HCPs; and monitoring measures, such as treatment dosage and care planning decisions based on the level of severity of each AE. Experts pointed out real-world challenges and local differences on AEs management and gave insight into implementation of regional strategies with a multidisciplinary collaboration approach. Dato-DXd AEs awareness, understanding, and proper management via a well-established multidisciplinary collaboration is crucial to guarantee patients’ quality of life. This international consensus aims to provide comprehensive recommendations for Dato-DXd AEs management, considering the regional and institutional differences present in the healthcare system, such as access to examinations and treatment possibilities.